Nursing educational framework: A new nurse-driven, conceptually guided approach.

PURPOSE: The aim of this article is to present the Nursing Educational Framework (NEF) as an opportunity to integrate core elements of a humanistic person/family-centered view and as guidance in structuring a relationship-based curriculum. DATA SOURCES: Empirical and theoretical literature studies were reviewed to define the framework rationale and its components. DATA SYNTHESIS: A deductive/inductive collaborative expert-informed approach was undertaken to develop this evidence-based codesigned framework. Its mission, along with unique components, implementation strategies, and outcomes, were successively integrated into the framework to guide nursing knowledge, learning, and curriculum development. A hermeneutic collaborative process of circular reflection was used in the development process. CONCLUSIONS: The NEF contains central guiding principles and concepts that are intended to provide structural consistency across its included programs from a humanistic person/family-centered approach. IMPLICATIONS FOR NURSING PRACTICE: This comprehensive theory-guided framework allows educators to suggest specific directions for nursing practice within the nursing discipline and articulate nursing's unique and specialized approach to promoting excellent patient care outcomes. It can assist students to develop critical lens from a person/family-centered relationship-based practice approach.

PROPÓSITO: El objetivo de este artículo es presentar el Modelo Formativo de Enfermería como una oportunidad para integrar los elementos principales de una visión humanística centrada en la persona/familia y como una guía para estructurar un currículo basado en la relación enfermera/paciente. FUENTES DE DATOS: Se revisó literatura teórica y empírica con el fin de definir las bases fundamentales del modelo y sus componentes. SÍNTESIS DE LOS DATOS: Con el fin de desarrollar el modelo, se planteó una aproximación deductiva/inductiva con enfoque colaborativo y basado en expertos. Su misión, junto con los componentes conceptuales más específicos, estrategias de implementación y resultados, fueron progresivamente integrados en él, para guiar el desarrollo del conocimiento, el aprendizaje y la conformación curricular. Se empleó un proceso hermenéutico colaborativo de reflexión circular. CONCLUSIONES: El modelo contiene los principios guía y conceptos que dan consistencia estructural a todos los programas incluidos, desde un punto de vista humanístico y centrado en la persona/familia. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: Este amplio marco teórico permite a los educadores sugerir direcciones específicas para la práctica de la enfermería dentro de la disciplina y articular su enfoque único y especializado para promover excelentes resultados en el cuidado del paciente. Puede ayudar a los estudiantes a desarrollar una lente crítica desde un enfoque de la práctica basada en la relación enfermera/paciente ycentrado en la persona y la familia.

[Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain].

BACKGROUND: Person-centred practices - following national and international developments in health-care policies - have become a key approach in healthcare. The Person-Centred Practice Inventory - Staff is an instrument based on the theoretical framework Person-Centred Practice that focuses on the staff's perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the first Spanish version of the PCPI-S translated and adapted into the Spanish context. METHODS: The translation and adaptation of the instrument followed the Translation and Cultural Adaptation of Patient Reported Outcomes Measures - Principles of Good Practice, which included a consulting session with experts. Content validation measures on clarity and relevance were assessed for every item (I-CVI) and the survey as a whole (S-CVI/Ave). RESULTS: No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtained excellent scores for clarity in 53 items and for relevance in 59; the S-CVI/Ave showed excellent results (=90). CONCLUSIONS: This first version of the Person-Centred Practice Inventory - Staff instrument adapted to the Spanish context is conceptually and semantically equivalent to the original one. This valuable tool will be of great help to identify the perception of healthcare professionals on person-centred practices.

Traducción y adaptación transcultural al contexto español del Person-Centred Practice Inventory-Staff (PCPI-S) para profesionales de la salud / Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain

Fundamento: El Cuidado Centrado en la Persona (CCP) se haconvertido en un tema central dentro del ámbito sanitario acorde con las políticas de salud nacionales e internacionales. ElPerson Centred Practice Inventory Staff (PCPI-S) es un instrumentobasado en el modelo teórico Person-Centred Practice Frameworkque evalúa la percepción que tienen los profesionales de la salud sobre una práctica centrada en la persona. El objetivo delestudio es obtener la primera versión española del PCPI-S traducido y adaptado a nuestro contexto español.Método: Se llevó a cabo una traducción y adaptación culturaldel instrumento utilizando la guía Translation and Cultural Adaptation of Patient Reported Outcomes Measures – Principles of GoodPractice (PGP) que incluyó una sesión con expertos. También serealizó una validación de contenido de la claridad y relevanciade cada ítem (I-CVI), así como del cuestionario total (S-CVI/Ave).Resultados: No se encontraron dificultades para llegar a unconsenso en los doce ítems que necesitaron ser clarificados. Elíndice de validez de contenido por ítem (I-CVI) obtuvo una puntuación excelente para claridad en 53 ítems, y para relevanciaen 59; el índice de validez de contenido del cuestionario (S-CVI/Ave) mostró resultados excelentes (≥90).Conclusiones: Se ha obtenido la primera versión del PCPI-Sadaptada al español, conceptual y semánticamente equivalenteal cuestionario original. Este instrumento permitirá identificarla percepción que tienen los profesionales de la salud sobre unapráctica centrada en la persona.(AU)

Background: Person-centred practices – following nationaland international developments in health-care policies – havebecome a key approach in healthcare. The Person-CentredPractice Inventory – Staff is an instrument based on the theo -retical framework Person-Centred Practice that focuses onthe staff’s perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the firstSpanish version of the PCPI-S translated and adapted into theSpanish context. Methods: The translation and adaptation of the instrumentfollowed the Translation and Cultural Adaptation of PatientReported Outcomes Measures – Principles of Good Practice,which included a consulting session with experts. Content validation measures on clarity and relevance were assessed forevery item (I-CVI) and the survey as a whole (S-CVI/Ave).Results: No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtainedexcellent scores for clarity in 53 items and for relevance in 59;the S-CVI/Ave showed excellent results (≥90).Conclusions: This first version of the Person-Centred PracticeInventory – Staff instrument adapted to the Spanish context isconceptually and semantically equivalent to the original one.This valuable tool will be of great help to identify the perceptionof healthcare professionals on person-centred practices.(AU)

Género y "domesticidad". Claves históricas de la relación terapéutica en el origen de la enfermería profesional norteamericana (1800-1860) / Gender and "domesticity" Historical keys to understand the therapeutic relationship in the origin of american professional nursing (1800-1860)

En la primera mitad del siglo XIX, los cuidados de salud que se administraban en el ámbito doméstico en los Estados Unidos de América eran transmitidos de madres a hijas como parte del aprendizaje cotidiano femenino. En el contexto de las relaciones terapéuticas que se establecían a pie de cama de quienes enfermaban, el ejercicio de los cuidados se entendía como una manifestación moral de la mujer hacia los suyos y un ejemplo de benevolencia femenina. Se produjo un cambio paulatino en el que influyeron los movimientos sociales en favor de las mujeres y el acceso a la educación. La investigación muestra un recorrido que permite comprender el contexto cotidiano como un elemento catalizador para la visibilidad, reconocimiento y legitimidad social de los cuidados realizados por las mujeres, y su papel en la profesionalización de la enfermería y en las relaciones que se establecían entre médicos, enfermeras y aquellos que enfermaban. El artículo propone una transición progresiva desde las prácticas de los cuidados en el ámbito doméstico al de la profesionalización de las mujeres como enfermeras.(AU)

In the first half of the 19th century, the health care administered in the domestic sphere in the United States of America was transmitted from mothers to daughters as part of women’s daily learning. In the context of the therapeutic relationships established at the bedside of those who were ill, the exercise of care was understood as a moral manifestation of women towards their loved ones, and an example of feminine benevolence. We observe that there was a gradual change that was influenced by social movements in favour of women and the access to education. The research shows a path that allows us to understand the domestic context as a catalyst for the visibility, recognition and social legitimacy of the care provided by women, and its role in the professionalization of nursing, and in the relationships established between doctors, nurses and those who fell ill. The article proposes a progressive transition from care practices in the domestic sphere to the professionalization of women as nurses.(AU)

The image of nursing in the media: A scoping review.

AIM: To systematically review the available evidence from research exploring the image of nurses in the media. BACKGROUND: Nurses have historically faced many challenges and have received media attention for such efforts. However, the image of nursing traditionally conveyed by media has failed to represent the real character and a positive image of the nursing profession. REVIEW METHODS: For this scoping literature review, a search was conducted in PubMed, CINAHL, Scopus, PsycINFO, Web of Science and Dialnet to identify studies written in English, Spanish or Portuguese from the earliest date in the databases until February 2022. Four authors were involved in a two-stage screening process. Data were subjected to quantitative content analysis. A decade-by-decade analysis was performed to track the evolution of the research. RESULTS: Sixty studies were included. The analysis shows (1) an increasing interest in analysing the portrayal of nurses and nursing in media over time, especially from 2000 onwards; (2) a prevailing trend of focusing on one form of media when analysing the portrayal of nurses; (3) qualitative designs as the most frequent method for exploring the image of nursing; and (4) a predominantly negative image conveyed by media. CONCLUSIONS: There is a notable body of scientific evidence about the image of nurses and nursing portrayed in media. The interest in analysing media depictions of nursing has a long history. The included studies' samples showed heterogeneity, as they were obtained from different media, periods and countries. IMPLICATIONS FOR NURSING: This scoping review is the first systematic review to provide a comprehensive map of what has been studied thus far regarding media depictions of nursing. It confirms the imperative need for nurses in different settings (academic, assistance or management fields) to maintain a proactive attitude towards addressing images of nursing and ensuring accurate representations.

The relationship competencies guiding tool: A development, content validation and implementation study.

AIM: The aims of this paper are (1) to present the results of the development, content validation and implementation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool. BACKGROUND: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented. DESIGN: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation. METHODS: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators. RESULTS: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process. CONCLUSIONS: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a measurement tool. TWEETABLE ABSTRACT: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/families, as reflected by nurses' clinical narratives.

Jane Stuart Woolsey and Hospital Days: The power of nursing training.

AIMS: To analyze the personal experiences of Jane Stuart Woolsey in Hospital Days (1868), an inspiring nurse who brought order, training and quality to nursing activities in the context of the American Civil War (1861-1865). BACKGROUND: In a restrictive context where the general access of women to public sphere activities was rather limited and where nursing was not a formally regulated professional activity, Jane Woolsey wrote Hospital Days to recount her wartime nursing experiences as the superintendent of Fairfax Seminary Hospital in Virginia. DESIGN: Historical research. METHODS: Historical research methods were used to analyze Hospital Days. Data gathered from primary and secondary sources were synthesized and discussed in terms of their historical context and significance. RESULTS: Unlike other triumphal narratives at the time, Woolsey develops a compelling account describing the work expected of a nurse and denouncing the lack of training among most nurses working in the war context. CONCLUSION: Jane Woolsey was a pioneering nurse who improved the quality of nursing care amidst the American Civil War. Her personal experiences collected in Hospital Days reflect her desire for the proper training of nurses and her contributions to emerging professional nursing activities built on the integration of previous domestic values, good training and good administration.

[Translation and transcultural adaptation of the theoretical Person-Centred Practice Framework to the Spanish context].

BACKGROUND: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context. METHODS: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. RESULTS: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence. Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (>0.90). CONCLUSIONS: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.

Traducción y adaptación transcultural al contexto español del marco teórico Person-Centred Practice Framework / Translation and transcultural adaptation of the theoretical Person-Centred Practice Framework to the Spanish context

Fundamento: El cuidado centrado en la persona se ha convertido en un enfoque esencial a nivel global que pretende dar respuesta a todas las dimensiones que afectan a los complejos procesos de la atención sanitaria. El Person-Centred Practice Framework (PCPF), desarrollado por McCormack y McCance facilita que los equipos multidisciplinares puedan entender y operativizar todas las dimensiones que participan en el desarrollo de una atención centrada en la persona. El objetivo del estudio fue obtener la primera versión española del marco PCPF traducida y adaptada a nuestro contexto español. Método: La traducción y adaptación transcultural del PCPF se acometió utilizando la guía Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures, que incluye una sesión con expertos. Además, se realizó una validación de contenido de la claridad y la relevancia de cada dominio. Resultados: No se encontraron dificultades relevantes para llegar a un acuerdo en la mayoría de los términos que necesitaron ser clarificados, a excepción del término Estar presente con pleno reconocimiento del otro, que fue el más complejo de traducir y adaptar culturalmente. Respecto a la relevancia y claridad, el índice de validez de contenido por constructo (I-CVI) y del marco global (S-CVI/Ave) mostraron excelentes resultados (≥0,90). Conclusiones: Se ha obtenido una versión adaptada al español clara, relevante y conceptualmente equivalente al marco PCPF original. La disponibilidad de este marco en español facilitará una mejor comprensión de la práctica centrada en la persona y favorecerá la implementación de este enfoque en la práctica clínica.(AU)

Background: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context. Methods: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. Results: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence .Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (≥0.90). Conclusions: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.(AU)

Mary Livermore and My Story of the War: A nurse's narrative journey.

Mary Livermore's My Story of the War is a valuable piece of travel writing written from the point of view of a nurse who documented her unexpected personal and professional journey to administer the Sanitary Commission of the United States Union Army and provide nursing care during the American Civil War. Although Livermore's pre-war background had not been solely limited to the domestic sphere, her wartime experience involved a public negotiation between the traditional domestic realm assigned to women and new nursing professional functions that emerged during the war. In a context in which the general access of women to public writing was rather limited and in which nursing was not a formally regulated professional activity, Livermore's triumphal narrative reflects the increasing connection between progressively professional nursing functions that emerged in the context of war and a new women's rights leadership forged during her autobiographical journey.

Nurses' continuing professional development: A systematic literature review.

Nurses' continuing professional development (CPD) improves the quality of nursing care, patients' safety, nurses' satisfaction and healthcare costs. However, evidence has shown that nurses do not always participate in their CPD and that CPD does not always address nurses' real needs. To examine this issue, a systematic review of the literature on nurses' experiences regarding their CPD in the clinical context was carried out. The studies selected for this review (n = 9) were analyzed thematically, through which three themes were identified: The relevance of CPD to nurses; the intrinsic and extrinsic motivations of nurses to participate in CPD; and the specific needs of nurses to participate in CPD. The findings of this review highlight that nurses' experiences regarding their CPD is a key issue that has not been deeply studied. For nurses, their CPD continues throughout their professional career, and keeping their knowledge and skills up to date is important. The goals, motivations and needs that nurses may have to lead and participate in their CPD may vary according to their age and position. Organizations should consider nurses' specific professional situation as well as their actual needs to boost their CPD through different approaches and enhance nurses' retention at hospitals.

Triumphal narratives in the American Civil War: A new nursing professional identity.

AIMS: To analyse the evolving social role of female nurses in the American Civil War context in terms of gender, class and race and to examine whether their caring efforts correspond to the beginnings of a new nursing professional identity. DESIGN: Historical research. METHODS: Thirteen American Civil War nurses' triumphal narratives written between 1865-1902 were analysed. The search and work were carried out between 2012-2020. Women's history and thematic analysis provided, respectively, the theoretical and analytical frameworks. RESULTS: The arrival of the war was the catalyst for change. The nurses' autobiographies were written in a hostile environment where class and racial tensions had to be released. This analysis points to nursing care being transformed from its traditional domestic traits to a progressive and intentional professional dimension. CONCLUSION: American Civil War nurses' autobiographies offer an innovative vision of their lives and their nursing work. Specifically, the autobiographical accounts provide new perspectives on the evolution of the authors' social dimension in terms of class, race and gender as well as the development of a new nursing professional identity in that context. Impact Illuminating overlooked meanings hidden in nurses' autobiographies improves women's visibility and their contribution to the history of nursing.

Implementation and evaluation of a training programme to promote the development of professional competences in nursing: A pilot study.

BACKGROUND: Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care. PURPOSE: To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. METHOD: Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. RESULTS: The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)]. CONCLUSIONS: The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.

Nursing narratives and reflective practice: A theoretical review.

AIM: To explore the literature regarding how nursing narratives have been used to enhance reflective practice. DESIGN: Theoretical review. DATA SOURCES: A literature search from 1990 - 2017 was conducted in PubMed, CINHAL and PsycINFO databases. REVIEW METHODS: After applying the selection criteria, 13 studies were identified. The quality of articles was evaluated. RESULTS: Three themes were identified as the main components of an ongoing narrative process based on looking back to past clinical experiences, creating spaces for dialogue and bringing the worlds of theory and practice closer together. CONCLUSIONS: This review provides a forum for exploring the use of narratives to enhance reflective practice, which may lead to the acquisition of professional competences.

Louisa May Alcott and Hospital Sketches: An innovative approach to gender and nursing professionalization.

AIM: To show the development of an emerging nursing profession through the eyes of Louisa May Alcott and Hospital Sketches. BACKGROUND: In Hospital Sketches, Louisa May Alcott recounts her experiences when she worked as a nurse of injured soldiers during the American Civil War, in an autobiographically and masked-referential way, which allows her to negotiate between transgression and convention. Unlike other reviews, in this paper the relevance of nursing remains highlighted. DESIGN: Discussion paper. DATA SOURCES: Existing literature in databases, history books and our own reading of facts. IMPLICATIONS FOR NURSING: Illuminating overlooked meanings hidden in nurses' personal sources enables to approach their contribution to history, improve their visibility and project the future of nursing. Nursing care, whether domestic or professional, was and remains a catalyst for change. CONCLUSION: Through Alcott's words, we understand the transition of nursing care as a gradual extension of the middle-class woman's domestic role and a progressive definition of nurses' identity. In particular, we highlight how certain professional nursing nuances which appear in the text are compatible with the gradual extension of the boundaries of women's domesticity. Furthermore, Alcott's use of literary devices reveals the delicate balance between women's domestic role and some new nursing professional features, which anticipates nursing professionalization.